多层螺旋CT灌注成像在肺癌与肺良性结节鉴别诊断中的应用

Application of multi slice spiral CT perfusion imaging in differential diagnosis of lung cancer and benign pulmonary nodules

目的:探讨多层螺旋CT(Multi slice helical CT,MSCT)灌注成像在肺癌与肺良性结节鉴别诊断中的应用。方法:选取2014年1月-2014年6月在我院行多层螺旋CT(Multi slice helical CT,MSCT)灌注成像检查的患者100例,包括恶性结节患者44例,良性结节患者22例,炎性结节患者34例,观察CT灌注参数值与肺结节、肺癌病理分型的关系。结果:恶性结节、良性结节和炎性结节的血流量(Blood flow,BF)值和平均通过时间(Mean transit time,MTT)值比较,差异无统计学意义(P>0.05)。恶性结节、良性结节和炎性结节的血容量(Blood volume,BV)值和表面通透性(Permeability surface,PS)值比较,差异均具有统计学意义(P<0.05),其中BV值:炎性结节最大、良性结节最小、恶性结节居中;PS值:恶性结节最大、良性结节最小、炎性结节居中。腺癌、鳞癌和小细胞肺癌的BV值、BF值、PS值和MTT值比较,差异无统计学意义(P>0.05)。但鳞癌的BF值显著低于腺癌和小细胞肺癌(P<0.05)。结论:多层螺旋CT灌注成像可参考灌注参数值的变化,鉴别肺癌与肺良性结节,具有重要的诊断价值。

Objective：To investigate the application of MSCT perfusion imaging in the differential diagnosis of lung cancer and benign pulmonary nodules.Methods：One hundred patients with MSCT perfusion imaging in our hospital from January to June in 2014 were selected,including 44 patients with malignant nodules,22 patients with benign nodules,and 34 patients with inflammatory nodules.The relationship between the value of CT perfusion parameters and the pathological types of lung nodules and lung cancer were observed.Results：There was no significant difference in blood flow（Blood flow,BF）and mean transit time（Mean transit time,MTT）in malignant nodules,benign nodules and inflammatory nodules（P〈0.05）.Malignant nodules,benign nodules and inflammatory nodules blood volume（Blood volume,BV）and permeability surface（Permeability surface,PS）value comparison,the differences were statistically significant（P〈0.05）,the BV value of inflammatory nodules was the largest,the value of benign nodules was the smallest,and the value of malignant nodules was in the middle.The PS value of the malignant nodules was the largest,the value of benign nodules was the smallest,and value of inflammatory nodules was in the middle.There was no significant difference in BV value,BF value,PS value and MTT value among adenocarcinoma,squamous cell carcinoma and small cell lung cancer（P〈0.05）.However,the BF value of squamous cell carcinoma was significantly lower than that of adenocarcinoma and small cell lung cancer（P〈0.05）.Conclusion：MSCT perfusion imaging can be used to identify the benign nodules and lung cancer.